DE2917783C2 - Forceps for applying a clip to a fallopian tube - Google Patents
Forceps for applying a clip to a fallopian tubeInfo
- Publication number
- DE2917783C2 DE2917783C2 DE2917783A DE2917783A DE2917783C2 DE 2917783 C2 DE2917783 C2 DE 2917783C2 DE 2917783 A DE2917783 A DE 2917783A DE 2917783 A DE2917783 A DE 2917783A DE 2917783 C2 DE2917783 C2 DE 2917783C2
- Authority
- DE
- Germany
- Prior art keywords
- shaft
- clip
- sleeve
- pliers
- forceps
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F6/00—Contraceptive devices; Pessaries; Applicators therefor
- A61F6/20—Vas deferens occluders; Fallopian occluders
- A61F6/202—Means specially adapted for ligaturing, compressing or clamping of oviduct or vas deferens
- A61F6/204—Clamp applying devices
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- Health & Medical Sciences (AREA)
- Reproductive Health (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Description
Die Erfindung bezieht sich auf eine Zange zum Anlegen eines Clips an einen Eileiter mit den Merkmalen des Oberbegriffes des Anspruches I.The invention relates to forceps for applying a clip to a fallopian tube with the Features of the preamble of claim I.
Bekannte Zangen der vorerwähnten Art, z. B. nach der DE-OS 28 28 564 und DE-OS 28 56 241 sind so ausgebildet, daß der in das Zangenmaul eingelegte Clip sich durch elastische Ausbildung mit seinem Schenkeln unter distalscitiger öffnung spreizt. Solche Zangen müssen zum Anlegen des Clips an einen Eileiter durch eine durch die Bauchdecke geführte Trokarhülse eingeführt werden. Dabei muß der gespreizte Clip in eine Stellung gebracht werden, in der er durch die Trokarhülse hindurchschiebbar ist, d. h. die Spreizung ist rückgängig zu machen, aber die Clipschenkel dürfen sich dabei mit ihren freien Enden noch nicht in Kuppeleingriff befinden. Zu diesem Zweck ist der doppelarmige Schließhebel des Zangenmaules mit dem gegen die gespreizten Clipschenkel arbeitenden Hebelarm in spezieller Weise ausgebildet Der Schließhebel muß zum Einlegen des Clips zunächst geöffnet und nach Einlegen des Clips geschlossen werden, um den gespreizten Clipschenkel in die mit der Trokarhülse fluchtende Lage zu bringen. Nach Durchführen des Clips durch die Trokarhülse muß durch die Betätigung der Zangenhandhabe der Schließhebel und damit der Clip wieder geöffnet werden, um ihn um den Eileiter herumlegen zu können, worauf das Zangenmaul durch die Zangenhandhabe vorgeschoben und schließlich der Schließhebel in die Schließlage geschwenkt wird, in der die beiden freien Enden der Clipschenkel in hakenförmigen Kuppeieingriff gebracht werden.Known pliers of the aforementioned type, e.g. B. according to DE-OS 28 28 564 and DE-OS 28 56 241 are so designed that the clip inserted into the jaws of the pliers is elastic with its legs spreads under the distal opening. Such forceps must be used to apply the clip to a fallopian tube a trocar sleeve inserted through the abdominal wall. The spread clip must be in brought into a position in which it can be pushed through the trocar sleeve, d. H. the spread is to be reversed, but the clip legs must not yet move in with their free ends Coupling engagement. For this purpose, the double-armed locking lever of the pliers jaws with the Lever arm working against the splayed clip legs is designed in a special way. The locking lever must first be opened to insert the clip and closed after inserting the clip in order to remove the to bring the splayed clip leg into the position in alignment with the trocar sleeve. After running the Clips through the trocar sleeve must be actuated by the forceps handle of the locking lever and thus the The clip can be opened again in order to be able to place it around the fallopian tube, whereupon the forceps jaws through the pliers handle is advanced and finally the locking lever is pivoted into the closed position in which the two free ends of the clip legs are brought into hook-shaped dome engagement.
Bei einer weiteren bekannten Zange (DE-OS 25 53 540) zum Anlegen eines Clips der eingangs erwähnten Art an einen Eileiter ragt ein Schließhebel mit festliegender Schwenkachse ständig aus dem distalen Ende des Schaftes heraus und nimmt in der Ruhelage eine etwa parallele Lage zum gespreizten Schenkel des Clips ein. Zum Durchschieben der Zange durch eine Trokarhülse muß der Schließhebel durch eine Handhabe soweit gegen den gespreizten Schenkel verschwenkt werden, daß er gemeinsam mit diesem gespreizten Schenkel mit dem Schaft fluchtet, aber noch nicht in die Kuppellage gelangt. Diese Lage des Schließhebels muß der Arzt mittels der Handhabe zum Durchführen der Zange durch die Trokarhülse genau beibehalten, um ein unbeabsichtigtes Kuppeln der Clipschenkel zu vermeiden. Außerdem führt die festliegende Schwenkachse des Schließhebels zu einer erheblichen Durchmesservergrößei eng des Zangenschaftes und der Trokarhülse, was zu größeren Durchstichen durch die Bauchdecke führtIn another known pair of pliers (DE-OS 25 53 540) for creating a clip of the entrance mentioned type on a fallopian tube a locking lever with a fixed pivot axis protrudes constantly from the distal end of the shaft and takes an approximately parallel position to the spread in the rest position Leg of the clip. To push the forceps through a trocar sleeve, the locking lever must through a handle can be pivoted against the splayed leg that it is together with this splayed thigh is aligned with the shaft, but still does not get into the coupling position. This position of the locking lever must be used by the doctor using the handle Passing the forceps through the trocar sleeve is precisely maintained to avoid inadvertent coupling of the Avoid clip legs. In addition, the fixed pivot axis of the locking lever leads to a considerable diameter enlargement of the pliers shank and the trocar sleeve, which results in larger punctures through the abdominal wall
Die Aufgabe der Erfindung besteht darin, die Ausbildung, Handhabung und Betätigung des Schließhebels der Clipzange wesentlich zu vereinfachen, den Durchmesser des Zangenschaftes so klein wie möglich zu halten und auch von der Geschicklichkeit des Arztes, unabhängig zu werden.The object of the invention is the training, handling and actuation of the locking lever To simplify the clip pliers significantly, the diameter of the pliers shaft as small as possible and also to become independent of the doctor's skill.
Diese Aufgabe wird bei der eingangs erwähntenThis task is mentioned in the introduction
so Zange nach der Erfindung dadurch gelöst, daß der Schließhebel zu dem in seinem Schwenkbereich liegenden gespreizten Clipschenkel eine etwa parallel« Rahelage einnimmt und durch die Handhabe hinter den Clip bewegbar und in die mit dem Schaft fluchtende Lage verschwenkbar ist.so pliers according to the invention solved in that the locking lever to the in its pivoting range lying spread clip leg assumes an approximately parallel «frame position and through the handle behind the Clip can be moved and pivoted into the position in alignment with the shaft.
Durch diese Lösung kann der Durchmesser des Zangenschaftes gering gehalten werden, kann der Clip geöffnet ohne Betätigung der Handhabe in das Auflager im distalen Schaftende eingelegt und die mit dem Schalt fluchtende Lage des Schließhebels durch axiales Verschieben und Verschwenken durch Betätigen der Handhabe gegen seine Abfederung erreicht werden. Nach Durchführen der Zange in dieser Lage des Schließhebels und des ebenfalls in die mit dem Schaft fluchtende Lage des spreizbaren Clipschenkels durch die Trokarhülse kehrt der Schließhebel automatisch durch die Federung der Handhabe in die Ruhelage zurück und ebenso spreizt sich der Clip wiederWith this solution, the diameter of the pliers shaft can be kept small, the clip opened without actuating the handle inserted into the support in the distal end of the shaft and with the switch aligned position of the locking lever by moving axially and pivoting by pressing the Handle can be achieved against its cushioning. After passing through the pliers in this position of the Closing lever and also in the aligned position of the expandable clip leg with the shaft The locking lever automatically returns the trocar sleeve to the rest position due to the suspension of the handle back and the clip spreads again
automatisch. Per Clip kann dann unter Beobachtung auf einen Eileiter aufgeschoben werden und dann wird durch Betätigung der Handhabe der Schließhebel den gespreizten Clipschenkel in die Kupplungslage mit dem festliegenden Clipschenkel drücken.automatically. A clip can then be viewed under observation an fallopian tube can be pushed open and then by operating the handle of the locking lever the Press the spread clip leg into the coupling position with the fixed clip leg.
Vorteilhaft wird nach einer weiteren Ausbildung der Erfindung so vorgegangen, daß nach Verschwenken des Schließhebels in die mit dem Schaft fluchtende Lage eine Zylinderhülse auf dem Schaft zum distalen Schaftende verschiebbar ist und den gespreizten Clipschenkel ohne Kuppeleingriff mit dem festliegenden Clipschenkel in die mit dem Schaft fluchtende Lage bringtAdvantageously, according to a further embodiment of the invention, the procedure is that after pivoting the Closing lever in the aligned position with the shaft a cylinder sleeve on the shaft to the distal The end of the shaft is displaceable and the splayed clip leg without coupling engagement with the fixed Brings clip leg into the aligned position with the shaft
Dadurch wird vermieden, daß der gespreizte Clipschenkel zum Durchführen durch die Trokarhülse mit der Hand in die mit dem Schaft fluchtende aber noch nicht gekuppelte Lage gebracht werden muß, die nun durch die Zylinderhülse gewährleistet wird und die beim Durchschieben der Zange durch die Trokarhülse am proxi malen Ende der Trokarhülse festgehalten wird, so daß der sich etwas spreizende Clipschinkel dann an der Innenfläche der Trokarhülse entlanggieitet und sich bei Austritt aus der Trokarhülse voll zum gesteuerten Anlegen an den Eileiter spreiztThis avoids having the splayed clip limb to pass through the trocar sleeve must be brought by hand into the position that is aligned with the shaft but not yet coupled, which now is guaranteed by the cylinder sleeve and when the forceps are pushed through the trocar sleeve on the proxi paint end of the trocar sleeve is held so that the slightly spreading clip angle then at the Gitet along the inner surface of the trocar sleeve and fully to the controlled when exiting the trocar sleeve Spreads it against the fallopian tube
Die Erfindung wird nachstehend anhand der schematischen Zeichnung erläutert, in der ein Ausfertigungsbeispiel dargestellt ist Es zeigtThe invention is explained below with reference to the schematic drawing in which an exemplary embodiment is shown It shows
F i g. 1 die Zange zum Anlegen eines Clips an einen Eileiter nach Durchführung durch eine Trokarhülse in SeitenansichtF i g. 1 the forceps for applying a clip to a fallopian tube after passing through a trocar sleeve in Side view
F i g. 2 das distale Ende der Clipzange mit Zylinderhülse vor dem Durchführen des Clips und der Zange durch die Trokarhülse im AchsschnittF i g. 2 the distal end of the clip forceps with cylinder sleeve before the clip and the forceps are passed through through the trocar sleeve in axial section
F i ς. 3 das distale abgeänderte Ende der Clipzange in Seitenansicht,F i ς. 3 the distal modified end of the clip forceps in side view,
F i g. 4 einen Achsschnitt durch eine gegenüber F i g. 2 abgeänderte Zylinderhülse für die Anwendung bei einer Zange mit der Abänderung nach F i g. 3.F i g. 4 shows an axial section through a compared to FIG. 2 modified cylinder sleeve for use with a Pliers with the modification according to FIG. 3.
Bei der Clipzange nach der Erfindung und dem Beispiel handelt es sich um eine solche, wie sie im Prinzip in der Patentanmeldung P 28 28 564.5 mit Zusatzanmeldung P 28 56 241.6 beschrieben ist.When the clip pliers according to the invention and the example is such as it is in Principle in patent application P 28 28 564.5 with additional application P 28 56 241.6 is described.
Es sind daher die Bezugszeichen dieser beiden Anmeldungen für entsprechende Teile der vorliegenden Erfindung übernommen worden.It is therefore the reference numerals of these two applications for corresponding parts of the present Invention has been adopted.
Die Zange zum Anlegen eines z. B. aus elastischem Kunststoff bestehenden Clips 3 besteht aus einem Schaft 1, der distal einseitig ausgeschnitten ist und hier bei Xa ein Bett Xb, Ic zum Einlegen eines Clips 3 bildet, der aus dem im Bett Xb, Ic festliegenden Schenkel 5 mit einem Kupplungshaken 4 und der elastischen Verbindungslasche 6 zum Spreizen des Schenkels 7 besteht und der im Bett durch seitliche Zapfen 8 festgehalten wird, die sich auf seitliche Flansche des festliegenden Schenkels 5 auflegen. Die Sprsizlage des Clips 3 ist in Fig. 1 dargestellt. An das Bett Xb, Ic schließt sich proximalwärts ein doppelarmiger Schließhebel mit dem Arm 12 mit Vorsprung 13 und dem Arm 19 an. Der doppelarmige Hebel 12, 19 ist bei Il im distalen Ende eines im Zangenschaft 1 axial gegen eine nicht dargestellte Feder distalwärts verschiebbaren Zylinders 9 gelagert, durch den ein Gestänge 17 verläuft, welches distal mit dem Schließhebelarm 19 bei 18 gelenkig verbunden ist und proximal durch einen abgefederten Arm 23 eines Scherengriffes distalwärts relativ zum ^ Zylinder 9 verschiebbar ist. Der Scherenschenkel 23 ist an dem am Schaft 1 befestigten Scherenschenkel 25 schwenkbar angelenkt und durch eine Feder 50 gegen den Schenkel 25 gespreizt Entsprechend der Ausführung nach der DE-OS 28 56 241 wird durch Zusammendrücken des Scherengriffes 23, 25 gegen die Federung 50 der Schließhebel 12,19 unter gleichzeitiger Betätigung des Griffhebels 27 proximalwärts mittels des Zylinders 9 und des Gestänges 17 zurückgezogen und dabei schließt sich der Schließhebel 12, 19 in eine parallel zur Schaftachse befindliche Lage, die zunächst beibehalten wird. In dieser Lage des Schließhebels entsprechend Fig.2 ist aber der Clip 3 durch seine eigene Elastizität gespreiztThe pliers for applying a z. B. consisting of elastic plastic clip 3 consists of a shaft 1, which is cut out on one side distally and here at Xa forms a bed Xb, Ic for inserting a clip 3, which consists of the leg 5 fixed in bed Xb, Ic with a coupling hook 4 and the elastic connecting strap 6 for spreading the leg 7 and which is held in the bed by lateral pins 8 which rest on the lateral flanges of the fixed leg 5. The spray position of the clip 3 is shown in FIG. A double-armed locking lever with the arm 12 with projection 13 and the arm 19 adjoins the bed Xb, Ic in the proximal direction. The double-armed lever 12, 19 is mounted at Il in the distal end of a cylinder 9 axially displaceable in the forceps shaft 1 against a spring, not shown, through which a rod 17 extends, which is articulated distally to the locking lever arm 19 at 18 and proximally by a sprung arm 23 of a scissors handle is displaceable distally relative to the ^ cylinder 9. The scissor arm 23 is pivotably articulated to the scissor arm 25 attached to the shaft 1 and spread by a spring 50 against the arm 25 , 19 withdrawn with simultaneous actuation of the handle lever 27 proximally by means of the cylinder 9 and the linkage 17 and the locking lever 12, 19 closes in a position parallel to the shaft axis, which is initially maintained. In this position of the locking lever according to FIG. 2, however, the clip 3 is spread apart by its own elasticity
Der Clip 3 muß nun zum Anlegen an einen Eileiter mit der Zange durch eine durch die Bauchdecke der Patientin laufende Trokarhülse 51 mit TrompetenventilThe clip 3 must now be applied to a fallopian tube with the forceps through a through the abdominal wall of the Patient running trocar sleeve 51 with trumpet valve
52 hindurchgeführt werden. Zu diesem Zweck muß der gespreizte Clip 3 in eine Lage gebracht werden, in der der gespreizte Schenkel 7 mit der Innenfläche der Trokarhülse 51 fluchtet und der Schließhebel 12,19 muß durch Handhabung in die Schließlage nach F i g. 2 gebracht werden.52 are passed through. For this purpose, the spread clip 3 must be brought into a position in which the spread leg 7 is aligned with the inner surface of the trocar sleeve 51 and the locking lever 12, 19 must by handling in the closed position according to FIG. 2 are brought.
Um dies auf einfache Weise zu e , -ziehen, wird nach einer weiteren Ausbildung der Erfindung nach F i g. 2, in der die Clipschenkel mit ihren freien Enden, die aber noch nicht hintereinandergreifen bzw. nicht gekuppelt sind, auf das distale Ende des Zangenschaftes 1 eine Zylindf=-hülse 53 aufgeschoben, die den zurückgedrückten Cliphebel 7 in der Lage nach F i g. 2 festhält Diese Zylinderhülse 53 wi.-d dabei an einem proximalen Ringflansch 54 erfaßt und ist im Bereich des Flansches 54 mit einer inneren Ringnut verse'nen; in die ein federnder, geschlitzter Ring 55 einpaßt, der beim Aufschieben der Hülse 53 in eine flache äußere Ringnut 56 des Zangenschaftes 1 eingreift und die Hülse 53 mit geringer Federkraft gegen axiale Verschiebung auf dem Schaft 1 festhältTo do this in a simple way, pull, after a further embodiment of the invention according to FIG. 2, in which the clip legs with their free ends, but which not yet engage one behind the other or are not coupled, on the distal end of the forceps shaft 1 a Cylinderf = sleeve 53 pushed back, the pushed back Clip lever 7 in the position according to FIG. 2 holds this cylinder sleeve 53 wi.-d while on a proximal The annular flange 54 is covered and is verse'nen in the area of the flange 54 with an inner annular groove; in the one resilient, slotted ring 55 fits, which when the sleeve 53 is pushed into a flat outer annular groove 56 of the pliers shaft 1 engages and the sleeve 53 with a low spring force against axial displacement on the Shank 1 holds
In dieser Anordnung der Zange wird das distale Zangenende mit der Zylinderhülse 53 in das proximale Ende der mit einem gegenüber der Zylinderlinse 53 größeren Innendurchmesser versehenen Ti okarh^lse 51 eingeführt, bis der Ringflansch 54 durch das proximale Stirnende der Trokarhülse 51 festgehalten wird oder bei einc-m größeren Außendurchmesser der ZylinderhülseIn this arrangement of the forceps, the distal forceps end with the cylinder sleeve 53 is inserted into the proximal end End of the Ti okarh ^ lse 51 provided with an inside diameter larger than the cylindrical lens 53 inserted until the annular flange 54 through the proximal Front end of the trocar sleeve 51 is held or with a larger outer diameter of the cylinder sleeve
53 gegenüber dem Innendurchmesser der Trokarhülse 51 legt sich das distale Ende der Zylinderlinse gegen die proximale Stirnseite der Trokarhülse. Durch Axialdruck wird dann der Eingriff des Federringes 55 in die flache Umfangsnut 56 des Zangenschaftes 1 aufgehoben, so daß sich beim distalen Weiterschieben der Zange 1 die Zylinderhülse 53 im proximalen oder vor dem proximalen Ende der Trokarhülse auf dem Zangenschaft verschiebt, der dabei durch die Trokarhülse hindurchgelangt, wobei sich der Clipschenkel 7 etwas spreizt und an der Innenfläche der Trokarhülse 51 entle'igjleitet, bis er sich am äußeren distalen Ende der Trokarhülse 51 wieder in die Offenlage spreizen kann, wie in F i g. 1 gezeigt ist.53 opposite the inner diameter of the trocar sleeve 51, the distal end of the cylinder lens lies against the proximal end face of the trocar sleeve. Axial pressure then engages the spring ring 55 in the flat Circumferential groove 56 of the forceps shaft 1 canceled, so that when the forceps 1 is pushed further distally, the Cylinder sleeve 53 in the proximal or in front of the proximal end of the trocar sleeve on the forceps shaft moves, which passes through the trocar sleeve, the clip leg 7 slightly spreads and entle'igjleitet on the inner surface of the trocar sleeve 51 until it is at the outer distal end of the Trocar sleeve 51 can spread again into the open position, as shown in FIG. 1 is shown.
In dieser Stellung kann der Clip in üblicher Weist unter Beobachtung mittels der Zange an den Eileiter herangebracht und über den Eileiter geschoben werden.In this position, the clip can be brought up to the fallopian tube in the usual manner while being observed using the forceps and pushed over the fallopian tube.
Sobald der Clip 3 und der Schließhebel 12, 19 die Trokarhülse 51 passiert hat, kann die Zange bzw. der Schließhebel durch Spreizen der beiden Scherengriffe 23, 25 in der Körperhöhle wieder geöffnet werden, wobei der Schließhebel 12, 19 durch die Abfederung 50 des Zangengriffes zum distalen Ende bewegt wird und nun die Stellung nach Fig. I einnimmt. Nachdem der Clip über den Eileiter geschoben ist, wird durch Zusammendrücken des Scherengriffes 23, 25 gegen dieAs soon as the clip 3 and the locking lever 12, 19 has passed the trocar sleeve 51, the forceps or the The locking lever can be opened again by spreading the two scissor handles 23, 25 in the body cavity, wherein the locking lever 12, 19 is moved to the distal end by the cushioning 50 of the forceps grip, and now the position according to FIG. After the clip is pushed over the fallopian tube, it is through Compression of the scissors handle 23, 25 against the
Federung 50 der Schließhebel 12 gegen den Clipschenkel 7 verschwenkt und dieser Schenkel 7 soweit angedrückt, daß das freie Ende des Schenkels 7 hinter den Haken 4 des Clipschenkels 5 zum Eingriff kommt. Sodann wird der Schließhebel 12,19 wieder automatisch durch die Feder 50 geöffnet, so daß nunmehr der über den Eileiter geklemmte Clip mittels der Auswerferstange 29 durch Betätigung der proximalen Mechanik 28 aus der Zange ausgeworfen wird. Nach dem Auswerfen wird der Schließhebel 12, 19 wieder in die Lage nach Fig. 2 gebracht und nunmehr kann die Zange proximalwärts durch die Trokarhülse 51 aus der Körperhöhle herausgezogen werden.The suspension 50 of the locking lever 12 is pivoted against the clip leg 7 and this leg 7 so far pressed so that the free end of the leg 7 behind the hook 4 of the clip leg 5 comes into engagement. Then the locking lever 12,19 is automatically opened again by the spring 50, so that now the over the fallopian tube clamped clip out by means of the ejector rod 29 by actuating the proximal mechanism 28 the forceps is ejected. After ejection, the locking lever 12, 19 is back in the position after Fig. 2 brought and now the forceps can proximally through the trocar sleeve 51 from the Body cavity can be pulled out.
Anstelle der Zylinderhülse 53 nach F i g. 2 kann auch eine Zylinderhülse 53a nach F i g. 4 /ur Anwendung kommen, jedoch setzt das voraus, daß der Zangenschaft 1 entsprechend F i g. 3 über eine distale Lange Ic/im Durchmesser gegenüber dem des Schaftes I abgestuft vergrößert ist. Entsprechend vergrößert ist derInstead of the cylinder sleeve 53 according to FIG. 2, a cylinder sleeve 53a according to FIG. 4 / ur application come, however, that assumes that the pincer shaft 1 according to FIG. 3 over a distal length Ic / im Diameter compared to that of the shaft I is increased in steps. The is enlarged accordingly
Diese Zylinderhülse 5Ja besitzt proximal einen Stutzen (54a/ der gegenüber dem inneren Durchmesser der Hülse 53;) durch eine Abstufung mit einem nach außen versetzten axial gerichteten Innengewinde 54c versehen ist. In dieses Innengewinde ist das Außengewinde eines Zylinderringes (54b) einschraubbar, dessen Innendurchmesser kleiner ist als der Innendurchmesser der Zylinderhülse 53a und dem Außendurchmesser des Zangenschaftes I entspricht. Zwischen den zugekehrten Stirnflächen der Stutzenabstufung und des Zylinderringes 54a, b ist mindestens ein elastischer O-Ring 54d eingelegt.This cylinder sleeve 5Ja has a proximal connection (54a / which is provided opposite the inner diameter of the sleeve 53;) by a step with an axially directed internal thread 54c offset to the outside. The external thread of a cylinder ring (54b) , the internal diameter of which is smaller than the internal diameter of the cylinder sleeve 53a and corresponds to the external diameter of the pliers shaft I, can be screwed into this internal thread. At least one elastic O-ring 54d is inserted between the facing end faces of the connecting piece gradation and the cylinder ring 54a, b.
in Der Ring 54f> bleibt ständig auf dem Schaft 1, während die den Clipschenkel 7 in die nicht gekuppelte Schließlage brinpbare Zylinderhüke 53 mit dem beim Durchführen djs Zangenschaftes I durch die proximak-Stirnseite der trokarhülse 51 /.iirückgehalU'ne Ring-in the ring 54f> remains permanently on the shaft 1, while the cylinder hatch 53 which can be brought into the uncoupled closed position with the at Pass the forceps shaft I through the proximak face the trocar sleeve 51 /.
r> flansch 54a nach lösen der Schraubverbindung vom Schaft 1 über die dislale Schaftcrweiteriing li/. /um Zwecke der Reinigung und Sterilisation abgc/ogen werden kann.r> flange 54a after loosening the screw connection from Shaft 1 over the distal shaft extension left /. /around Purposes of cleaning and sterilization can be discarded.
Die Anwendung der Hülse 53, 54 nach I·'i g. 4The use of the sleeve 53, 54 according to I · 'i g. 4th
ir. cn:spr;eh: hierbei irr •.vi.-.cn'.üchc:! der Msilvc 53, 54 nach I i g. 2 und ist in der Beschreibung /u F i g. 2 ausführlich behandelt ir. cn: spr; eh: here irr • .vi .-. cn'.üchc :! the Msilvc 53, 54 according to I i g. 2 and is in the description / u F i g. 2 dealt with in detail
Hierzu 1 Blatt Zeichnungen1 sheet of drawings
Claims (5)
Priority Applications (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE2917783A DE2917783C2 (en) | 1979-05-03 | 1979-05-03 | Forceps for applying a clip to a fallopian tube |
US06/143,949 US4325377A (en) | 1979-05-03 | 1980-04-25 | Surgical forceps for applying clips to fallopian tubes |
FR8009705A FR2455453A1 (en) | 1979-05-03 | 1980-04-29 | PLIERS FOR PLACING STAPLES ON THE TRUMPS |
GB8014025A GB2048685B (en) | 1979-05-03 | 1980-04-29 | Surgical forceps for applying clips |
IT8021794A IT8021794A0 (en) | 1979-05-03 | 1980-05-05 | FORCEPS FOR THE APPLICATION OF STAPLES TO THE OVIDUCT. |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE2917783A DE2917783C2 (en) | 1979-05-03 | 1979-05-03 | Forceps for applying a clip to a fallopian tube |
Publications (2)
Publication Number | Publication Date |
---|---|
DE2917783A1 DE2917783A1 (en) | 1980-11-06 |
DE2917783C2 true DE2917783C2 (en) | 1982-07-01 |
Family
ID=6069803
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE2917783A Expired DE2917783C2 (en) | 1979-05-03 | 1979-05-03 | Forceps for applying a clip to a fallopian tube |
Country Status (5)
Country | Link |
---|---|
US (1) | US4325377A (en) |
DE (1) | DE2917783C2 (en) |
FR (1) | FR2455453A1 (en) |
GB (1) | GB2048685B (en) |
IT (1) | IT8021794A0 (en) |
Families Citing this family (236)
Publication number | Priority date | Publication date | Assignee | Title |
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Family Cites Families (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3882854A (en) * | 1973-08-23 | 1975-05-13 | Research Corp | Surgical clip and applicator |
DE2553540A1 (en) * | 1975-11-28 | 1977-06-02 | Bleier Waldemar | Clamp for placing of fallopian tube clip - for operations using laparoscopy trocar and consisting of clip holding and closing devices |
US4169476A (en) * | 1977-08-12 | 1979-10-02 | Wolf Medical Instruments Corporation | Applicator for surgical clip |
DE2828564A1 (en) * | 1978-06-29 | 1980-01-10 | Wolf Gmbh Richard | PLIERS FOR APPLYING CLIPS TO ROPE LADDER |
DE2856241A1 (en) * | 1978-12-27 | 1980-07-17 | Wolf Gmbh Richard | Pliers for positioning unitary plastics clamps on blood vessels - has two articulating arms whose relative movement is governed by sliding rod in bore of one arm |
-
1979
- 1979-05-03 DE DE2917783A patent/DE2917783C2/en not_active Expired
-
1980
- 1980-04-25 US US06/143,949 patent/US4325377A/en not_active Expired - Lifetime
- 1980-04-29 FR FR8009705A patent/FR2455453A1/en active Granted
- 1980-04-29 GB GB8014025A patent/GB2048685B/en not_active Expired
- 1980-05-05 IT IT8021794A patent/IT8021794A0/en unknown
Also Published As
Publication number | Publication date |
---|---|
GB2048685B (en) | 1983-08-03 |
DE2917783A1 (en) | 1980-11-06 |
US4325377A (en) | 1982-04-20 |
FR2455453B1 (en) | 1983-07-01 |
FR2455453A1 (en) | 1980-11-28 |
IT8021794A0 (en) | 1980-05-05 |
GB2048685A (en) | 1980-12-17 |
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D2 | Grant after examination | ||
8339 | Ceased/non-payment of the annual fee |